Provider Demographics
NPI:1306686050
Name:HERSI, AMINA
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:HERSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 VICTORIA HILLS DR UNIT 302
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3883
Mailing Address - Country:US
Mailing Address - Phone:614-500-0489
Mailing Address - Fax:
Practice Address - Street 1:5471 SCIOTO DARBY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1310
Practice Address - Country:US
Practice Address - Phone:614-470-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.179364.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse